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General NPI Number Information
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NPI Number | 1851303325
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Entity Type | Individual
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Provider Name | THERESE M COLLIER CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 1000 E MAIN ST
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City | DANVILLE
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State | IN
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Zip | 46122-1948
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Country | US
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Telephone | 317-567-2180
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Fax | 317-567-2191
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Provider Business Mailing Address
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Address Line | 1000 E MAIN ST
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City | DANVILLE
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State | IN
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Zip | 46122-1948
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Country | US
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Telephone | 317-745-4451
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Fax | 317-718-6740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28070602
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License Number State | IN
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